Patient Information

Payment Options

Financial Policies

Please review our full Financial Policies for details on how we work with insurance as well as how we handle patient billing. If you have any questions, please call us or ask us in person at your next visit. We require all patients to sign this form.

Methods of Payment

For your convenience, we accept the following payment options:

  • Cash
  • Check
  • MasterCard
  • Visa
  • American Express
  • Discover
  • CareCredit®
  • GreenSky Patient Solutions

CareCredit®

CareCredit® is a program that allows us to offer interest-free payment terms to our patients. Not all dental practices offer this option, but it can be a tremendous financial aid to help fund your dental work. You can learn more at www.carecredit.com.

GreenSky Patient Solutions® Program®

The GreenSky Patient Solutions ® Program provides leading financial technology to healthcare providers throughout
the country. This technology offers fast, frictionless and attractive promotional financing options to patients who
qualify. Financing is provided by federally insured, equal opportunity banks. With the simple click of the mouse, this
secure service gives you access to:
• Easy application process
• Most loan decisions in minutes
• Multiple promotional financing options for qualified applicants
• Online tools to manage your account
Apply Now or Learn More and get the treatment you need now at a price you can afford.

Patient Forms

To help make your visits as short and simple as possible, we provide our patients with certain forms that you can fill out in advance.

Patient Forms

We use this information to make sure we understand your full medical and dental history and are aware of any current care, treatments, or issues you are experiencing. Please be as accurate and thorough as you can so that we may provide you with the best and safest care possible. Click here for our new patient form.

Health History Update
Please complete this form if you are a returning patient but it has been over a year since your last visit. The information you provide here will make us aware of any changes in your medical history or current treatments.

HIPPA Form
By signing this document, you acknowledge that you have been offered our Notice of Privacy Practices (below), in compliance with your rights under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

Notice of Privacy Practices
We provide our Notice of Privacy Practices here so that you may have a chance to read them and become familiar with them in advance. Please call us if you have any questions or concerns about these policies, or let us know during your visit how we can help clarify for you.

HIPPA and Patient Privacy Information

Whitefish Office

6516 Hwy 93 S, Whitefish, MT 59937

Kalispell Office

1874 Hwy 93 N, Kalispell, MT 59901

Call us today!

406-862-1010 Whitefish
406-730-1010 Kalispell

Book Appointment

customerconnect@mtlaserdetnistry.com